小动物内科学腹部x光解剖学

1、执业兽医师，欧洲兽医影像学认证兽医Radiographic anatomy of the abdomen腹部的X光解剖学Edoardo Auriemma, DVM, DipECVDIRadiographic anatomy ofthe abdomen 腹部X光解剖学Technique 技术Evaluation/anatomy abdominal radiographs:腹部X光的评估/解剖学:-Extra-abdominal structures 腹腔外结构Abdominal contrast 腹腔内结构的对比度Peritoneal VS retroperitoneal organs腹膜内器官

2、与腹膜后腔器官的比较-Not visible abdominal structures/contraststudies 不可见的腹腔结构/对比造影检查TechniqueExposure: Low Kvp High mAs technique（技术：低千伏高毫安秒技术 Espiration 在呼气时拍摄Radiographic anatomy of the abdomen腹部X光解剖学Technique 技术 Always two views 总是拍摄两个面的X光片 VD, LR/RL Lateral, DV views腹背位，左右侧位/右左侧位，背腹位投射 Entire abdomen整个腹腔

3、（膈-骨盆，背部，腹部和侧壁软组织边缘）Radiographic anatomy of the abdomen腹部X光解剖学Technique 技术Radiographic anatomy ofthe abdomen 腹部X光解剖学Standard views: VD and Lateral标准投射面：腹背位和侧位Always two orthogonal projections!总是要拍摄两个相互垂直的投射片！Two views!两个拍摄面！Radiographic anatomy ofthe abdomen 腹部的X光解剖学Extra-abdominal structures 腹外结构-R

4、adiographic anatomy: X光解剖学:Peritoneal 腹膜Retroperitoneal space 腹膜后腔Radiographic anatomy of the abdomen腹部X光解剖学Radiographic anatomy of the abdomen腹部X光解剖学Radiographic anatomy ofthe abdomen 腹部的X光解剖学 Extra-abdominal bony structures:腹外的骨质结构Lumbar vertebrae, pelvis, hind limbs腰椎，骨盆，后肢Abdominal walls (gas, m

5、ineralization, masses)腹壁（气体，矿化，肿块Perinal, inguinal regions 腹膜，腹股沟区域Abdominal contrast腹部对比造影Radiographic anatomy of the abdomen腹部X光解剖学Abdominal contrast 腹部对比造影Technique 技术Fat (amount of fat, “puppy fat”)脂肪（脂肪的数量，“幼犬脂肪”）Fluid 液体Peritonitis 腹膜炎Abdominal masses 腹部包块Survey radiographs 常规X光片Abdominal cont

6、rast 腹部对比造影Peritoneal space腹膜腔Cranial abdomen 颅侧腹部Diaphragm 膈Not entirely visible 不能完整看到R/L crura, intercrural cleft, cupula右/左膈脚，膈脚间隙，膈顶Variation in shape and position 形状和位置可变Sometimes rough ventral border L3-L4 (attachment pars lumbalis)有时大致位于第3第4腰椎的腹侧边缘（附着腰部）Cranial abdomen 颅侧腹部Liver 肝脏Uniform so

7、ft tissue opacity 均一的软组织不透明性Dogs symmetrically distributed 犬的为对称性的分布Cat mostly right hemiabdomen 猫大多位于右腹部Liver lobes, gallbladder not visible 肝叶，胆囊不可见Cranial abdomen 颅侧腹部Dog 犬Cat 猫Cranial abdomen 颅侧腹部Liver 肝脏Liver size usually best assessed on Lat view最好通过侧位片来进行评定肝脏大小Normal liver 正常肝脏Contained withi

8、n costal arch 位于肋弓内Sharp and pointed caudo-ventral margin具有在轮廓清晰且突出的后腹缘LiverHow about the liver size?肝脏肝脏的大小？Microhepatia 小肝Cranial abdomen 颅侧腹部Stomach 胃Dog: “U” shaped 犬：“U”型Cat: “J” shaped 猫：“J”型Fundus and corpus left hemiabdomen胃底和胃体占据腹部左半部Pyloric region right hemiabdomen dog犬腹部右半部份为幽门区域Pyloric r

9、egion across midline abdomen cat猫的胃幽门区域横跨腹正中线Cranial abdomen 颅侧腹部Stomach 胃Size, shape and opacity extremely variable大小，形状和不非常多变Gas and fluid patterns depending from positioning气体和液体的模式取决于具体的情况Gastric folds visible in obese cats肥胖的猫可以看到胃皱褶Cranial abdomen 颅侧腹部Stomach 胃DV 背腹侧VD 腹背侧Cranial abdomen 颅侧腹部S

10、tomach 胃RLat 右侧面LLat左侧面Cranial abdomenStomach 胃Gastric folds胃皱褶Mid-abdomen腹中部Mid-abdomen 腹中部Spleen 脾Relatively smaller in the cat as compared to the dog 与犬的相比，猫的脾相对较小Not entirely visible 不能完全看到Homogenous soft tissue opacity均质的软组织不透明性Mid-abdomen 腹中部Spleen 脾Lat view: 侧面观：Usually not visible in the cat

11、通常猫的脾是不可见的Head and tail visible in the dog犬的能看到脾头和脾尾VD view: 腹背位观：Head of the spleen visible both in thed the cat犬和猫均可见脾头Mid-abdomen 腹中部Spleen 脾Mid-abdomen 腹中部Small Intestine 小肠Smoothly marginated tubular or circular (if seen end- on) structures边缘光滑的管状或环状（如果能看到横切面）结构Opacity depends from intestinal c

12、ontent不取决于肠道内容物Normal size ? 正常大小？Mid-abdomen 腹中部Small Intestine 小肠Not exceeding twice rib widthNot exceeding height body L2Dog犬SI/L51.6小肠/第五腰宽度超过肋超过第二腰椎椎体的高度椎1.6骨宽度的两倍Not exceeding 12 mmNot exceedingCat猫twice the heightL4宽度12mm超过超过第四腰椎椎体高度的2倍Mid-abdomenMid-abdomenSmall Intestine 小肠Normal size ?正常的大

13、小？Mid-abdomenSmall Intestine 小肠Ileus!肠梗阻！Mid-abdomen 腹中部Large Intestine 大肠Cecum: “C” shaped in the dog (L2-L3)盲肠：犬的盲肠呈C型（第二腰椎-第三腰椎）Cecum: usually not visible in the cat盲肠：猫的通常不能看到Colon: question mark shape结肠：问号状的形状Mid-abdomen 腹中部Caudal abdomen尾侧腹部Homogeneous soft tissue opacity均质的软组织不 Oval shape, in

14、tra-abdominal or pelvic position in the dog犬的膀胱位于腹腔内或骨盆处，呈卵圆形 Ellipsoid and intra-abdominal position in the cat猫的膀胱在腹腔内，呈椭圆形Caudal abdomen 尾侧腹部Urinary bladder 膀胱Caudal abdomen 尾侧腹部Caudal abdomen 尾侧腹部Caudal abdomen 尾侧腹部ProstateSmall oval soft tissue opacity caudal to the urinary bladder in the dog犬的位

15、于膀胱后部，为小的卵圆形，表现为软组织不In normal castrated dog not visible在正常去势的犬上看不到Not visible in the cat 在猫上不可见Caudal abdomen 尾侧腹部ProstateSurvey radiographs常规X光片?Two soft tissue opacity: which one is the urinary bladder?两个软组织不透明阴影：哪一个是膀胱？Caudal abdomen 尾侧腹部Retroperitoneal space腹膜后间隙成对，具有均质的软组织不 Located at the level

16、 of L1-L3位于第一腰椎到第三腰椎的位置 Right kidney not completely visible右肾不能完全被看到（其边缘被肝尾叶遮住） Left kidney slightly caudal to right kidney左肾稍比右肾更靠近尾侧Retroperitoneal organs 腹膜外器官Kidneys 肾脏 Pair organs of homogenous soft tissue opacityRetroperitoneal organs 腹膜外器官Kidneys 肾脏-Size? 大小？Rule of thumb: 经验性标准：Dog: 2.5-3.5

17、times length of L2 (VD view)犬：第二腰椎长度的2.5-3.5倍（腹背侧观）-Cat: 2.4-3 times length of L2 (VD view)猫：第二腰椎长度的2.4-3倍（腹背侧观）Retroperitoneal organs 腹膜外器官Kidneys 肾脏Retroperitoneal organs 腹膜外器官?Retroperitoneal organs 腹膜外器官Survey radiographs 常规X光片Not visible structures 不可见的结构Pancreas 胰腺Abdominal lymph nodes and ves

18、sels腹部淋巴结和Uterus (non pregnant) and ovariesUrethra（未妊娠）和Ureters, adrenal glands, sublumbar lymph nodes输尿管，肾上腺，腰下淋巴结Retroperitoneal organs 腹膜外器官? ?Contrast studies对比造影检查Urinary tract 泌Contrast studies I对比造影检查IIntravenous pyelography (IVP), antegrade pyelography静脉肾盂造影（IVP），顺行肾盂造影Retrograde cystography 逆行膀胱造影Retrograde